A Hybrid Implementation-Effectiveness Trial of Nurse-Delivered Post-Traumatic Stress Disorder Treatment in Primary Care
Rush University Medical Center
Summary
Purpose of the Study Post-traumatic stress disorder (PTSD) is a common and serious condition, but many people cannot get the help they need because there are not enough mental health specialists (like psychologists or psychiatrists) available. This study is testing a new program called NurseNET. The goal of NurseNET is to train nurses to provide a proven, short-term trauma treatment called Narrative Exposure Therapy (NET). Why This Study is Important Most people see their nurse or doctor for health concerns. Because nurses are highly trusted and already work on the front lines of healthcare, they may be in the best position to offer PTSD treatment quickly and conveniently. This study aims to see if nurse-led care can bridge the gap between patients and the treatment they deserve. What the Study Involves Researchers will enroll 100 participants who have symptoms of PTSD. Participants will work with a trained nurse in a primary care setting to complete the NurseNET program. The Treatment: The program consists of 4 to 6 sessions. During these sessions, the nurse helps the patient talk through their life story and process difficult memories in a safe, supportive way. What We Are Measuring: The research team will look at several factors to see if the program is successful: Effectiveness: Do PTSD symptoms improve after working with the nurse? Feasibility and Acceptability: Do patients and nurses find this type of care easy to use and helpful? Health Impact: Since PTSD is linked to heart health, the study will also look at whether the treatment improves things like blood pressure or physical activity levels. Goal of the Research By the end of this study, researchers hope to show that nurses can safely and effectively provide trauma care. If successful, this model could be used across the United States to make PTSD treatment much easier to access for everyone.
Description
Background and Theoretical Framework This Type 2 Hybrid Implementation-Effectiveness Trial is designed to address the critical gap in posttraumatic stress disorder (PTSD) treatment for patients who have experienced co-occurring physical illness, namely cardiovascular (CV) events. Approximately one-third of CV event survivors develop PTSD, which serves as an independent risk factor for further CV morbidity and mortality. This study utilizes the Enduring Somatic Threat (EST) model, which posits that PTSD is driven by a persistent internal threat and can manifest as Fear-Related Behavioral Avoida…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * o PTSD + trauma exposure (PCL-5 score ≥28, plus trauma endorsed on LEC-5/CAPS) * Life-threatening CV event in the last 90 days (including myocardial infarction/heart attack, acute cerebrovascular accident/stroke, sudden cardiac arrest, acute decompensated heart failure, or life-threatening arrhythmia requiring cardioversion or defibrillation). * Primary care patient at Rush University Medical Center Exclusion Criteria: * o Safety risk (documented suicidal ideation/need for acute psychiatric care) * NET conflict (actively receiving psychotherapy/PTSD treatment)…
Interventions
- BehavioralNurseNET
NurseNET is a pragmatic clinical intervention designed to deliver evidence-based PTSD treatment within primary care workflows. It is distinguished from traditional Narrative Exposure Therapy (NET) and other primary care behavioral health interventions by the following four core elements: Nurse-Led Task Sharing. Unlike traditional models that rely on licensed mental health specialists (psychologists or social workers), NurseNET is delivered entirely by nurses. This leverages the existing nursing workforce to bypass specialist shortages and reduce the "referral cliff" associated with external mental health consultations. Dose-Compressed Protocol. While standard NET often extends to 10 or more sessions, NurseNET utilizes a condensed 4-session format. This "minimum therapeutic dose" is specifically engineered for the high-throughput U.S. healthcare environment. We use a safety-net supervision framework and leverage the holistic nurse preparation in the context of co-located/integrated care
- BehavioralReferral to PTSD Treatment
Standard referral to PTSD treatment.
Locations (2)
- Rush University Medical CenterChicago, Illinois
- Rush University Medical CenterBrookfield, Wisconsin